372. Advancing brain health through neurofeedback: a randomized controlled study on children’s executive function using P300 event related potential

Abstract

Abstract Background Deficits in executive function are common among school-age children and affect academic performance, self-regulation, and long-term brain health. These challenges emphasize the importance of early, evidence-based, and non-invasive interventions that support optimal brain development. Neurofeedback is a non-invasive, technology-based therapy grounded in neuroplasticity that enables regulation of brain activity through real-time feedback. Previous studies indicate potential improvements in attention, working memory, and learning. These cognitive processes can be objectively assessed using Event-Related Potentials (ERP), particularly the P300 component. However, evidence from Indonesian pediatric populations remains limited. Aims & Objectives This study aimed to evaluate the effectiveness of neurofeedback therapy in enhancing children’s executive function by examining changes in P300 parameters and executive function scores before and after intervention, as well as by comparing outcomes between intervention and control groups. Method A randomized controlled pretest–posttest design was employed. Ten students aged 10–12 years from an elementary school in West Java, Indonesia, were randomly assigned to a neurofeedback intervention group or a control group. Executive function was evaluated before and after using ERP P300 elicited by an auditory oddball paradigm and the Indonesian Executive Function Instrument (AUFEI). Neurofeedback training was delivered using the Neurosoft system, providing real-time visual and auditory feedback with threshold frequencies set between 5.0 and 15.0 Hz using a vertical racing feedback mode. The AUFEI-P is an instrument designed to assess executive function in Indonesian children from the parents’ perspective. The intervention was conducted for 5 weeks with 10 training sessions. Data were analyzed using paired and independent tests with a significance level of 0.05. This study was approved by Research Ethics Committee of UPNVJ (No. 83/VI/2025/KEP), and written informed consent was obtained from parents or legal guardians prior to participation. Results Observable changes in Event-Related Potential (ERP) P300 parameters were observed following neurofeedback training. Before intervention, mean P300 latency was 356.0 ms in the intervention group and 353.6 ms in the control group. After intervention, latency decreased to 302.8 ms in the intervention group and 311.6 ms in the control group, indicating a greater reduction in the intervention group. However, paired t-test analyses showed no statistically significant pre–post changes in either the intervention (p = 0.122) or control group (p = 0.099). Independent t-tests also revealed no significant differences between groups at baseline (p = 0.922) or post-intervention (p = 0.829). The lack of statistical significance is likely due to the limited sample size and relatively short training duration, which reduced statistical power. Nevertheless, the larger reductions in P300 latency and amplitude in the intervention group suggest early neurophysiological responses to neurofeedback training. Discussion & Conclusions Although statistically non-significant, the observed trends in P300 modulation suggest early neurophysiological responses to neurofeedback training that may reflect improvements cognitive related to executive function. These findings provide preliminary evidence supporting the potential role of neurofeedback in promoting children’s executive function and brain health. Further randomized controlled studies with larger sample sizes and longer intervention periods are warranted to confirm efficacy and strengthen the evidence base.